Location: This position will work a hybrid model (remote and office). Must reside within 50 miles/1 hour commute of our Miami or Tampa, FL Elevance Health location.
The Provider Collaboration Director-Value Based Care is responsible for local management of Enhanced Personal Health Care (EPHC), payment innovation programs and collaborative programs across all lines of business.
How you will make an impact:
Provides provider support for successful value based arrangements; lead committee meetings.
Drives medical and behavioral health integration initiatives.
Functions as company's SME in payment innovation and collaboration programs.
Manages and oversees the value-based programs
Identifies payment innovation gaps and engages appropriate resources for solution.
Analyzes financial performance quality metrics and reports to providers on the impact to performance.
Guides providers to move into more mature payment programs.
Conducts discussions with employer groups and health system executives.
Minimum Qualifications:
Requires a BA/BS degree and a minimum of 8 years' experience in contracting (value based, shared savings and Accountable Care Organization (ACO) development), provider relations, provider servicing; experience must include prior contracting experience; prior experience with oversight and responsibility of regulatory requirements for line of business supported; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
Experience using financial models and analysis to negotiate rates with providers strongly preferred.
Prior experience with provider network contracting, provider networks, claims, finance, and operations.
Experience with Medicaid, Medicare, and Commercial lines of business preferred.
MBA, MHA, or MA preferred.
PMP or Six Sigma Green Belt preferred.
MS Office Suite of Tools desired, advanced Excel experience preferred.
Strong understanding of healthcare ecosystem.
Strong understanding of Alternative Payment Methodologies (APM).
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
